Summary

The hip Single Assessment Numeric Evaluation (SANE) is an effective and efficient patient-reported outcome (PRO) to assess hip function when compared to the iHOT-12 PRO in an orthopaedic sports medicine subspecialty clinic.

Abstract

Objectives: Patient-reported outcome (PRO) measures are increasingly important and valuable tools in orthopaedics to objectively assess patient outcomes and guide decision-making. Though the Single Assessment Numeric Evaluation (SANE) scale has been validated for use with shoulder, knee, and foot injuries, it has yet to be heavily utilized for hip injuries. Our objective is to compare the hip SANE PRO to the previously validated iHOT-12 PRO at our orthopaedic sports medicine clinic.

Methods

We retrospectively reviewed a prospectively collected database of consecutive patients presenting to an orthopaedic sports medicine clinic with a primary complaint of “hip pain” from September 2020 to January 2021. Inclusion criteria was any patient presenting to clinic with a self-reported primary complaint of hip pain. The database consists of prospectively recorded iHOT-12 and hip SANE PRO measures collected via a secure software platform. Age and sex were also recorded. Data was analyzed from both new patients and the first episode of relevant data obtained from returning patients undergoing nonoperative treatment.

The original 33-question iHOT score measures health-related quality of life (QOL) and changes after treatment in young, active patients with hip disorders. This was later shortened to a 12-question PRO that accounts for 95% variation of the original version while achieving equivalent sensitivity to change. The SANE score was developed as a brief and efficient tool to subjectively assess the impact of a patient’s condition as well as improvement following orthopaedic treatment. In this study, the SANE score was administered as follows: “If 100% is perfectly normal, what percent of normal is your hip today?”. This question was modeled off previously validated shoulder, knee, and foot SANE questionnaires.

Results

A total of 460 patients met the study inclusion criteria, of which 282 were new to clinic and 178 were return patients. The mean age was 47.83 (SD +/- 16.94, range 13.02 to 87.36) of which 303 patients were female and 157 patients were male. The diagnoses of these patients presenting with a primary complaint of hip pain included conditions such as femoroacetabular impingement of the hip, lumbar radiculopathy, dysplasia, or labral tearing. The mean SANE and iHOT-12 scores for all patients were 47 and 48.38, respectively. The Pearson correlation coefficient between these two PRO measures was r = 0.700 (P = <0.005) for all patients representing a high correlation, of which r = 0.674 (P = <0.005) for new patients and r = 0.741 (P = <0.005) for return patients. These correlation values were analyzed separately, representing a moderate and high correlation for new and return patients, respectively.

Conclusion

In conclusion, this study uses a large dataset to demonstrate that the hip SANE score correlates well with the iHOT-12 score in hip patients presenting to an orthopaedic subspecialty clinic with a primary complaint of hip pain. This supports the use of the hip SANE score for a patient-reported outcome measure in this population. The SANE score may be a useful and efficient PRO measure to inform treatment decision-making and monitor outcomes following treatment of hip conditions.